Advance Care Planning: What's All the Talk About?

Abstract

The ethics of honouring an individual's wishes for health care are clear and unequivocal in health care literature and policy. Yet health care providers are often unsure how to proceed, both in initiating an advance care planning conversation and in respecting an advance directive once a person is no longer capable of communicating. While advance directives are supported under the Canadian common law, provincial legislation differs across the country, and can create barriers to effective advance care planning.

The purpose of this article is to describe an advance care planning project undertaken by a large Canadian health authority that shifted the focus away from the document and onto the conversation. Fraser Health's “Let's Talk” initiative promotes the importance of advance care planning conversations while adults are healthy and capable and supports health care professionals in facilitating these conversations. This article will also address the system barriers and broad implementation challenges faced in the context of the Canadian health care and legal environment.